LATE RESULTS OF ILIOFEMORAL VENOUS THROMBECTOMY

Purpose: Although anticoagulation therapy for iliofemoral venous throm bosis prevents pulmonary embolism, it is not designed to avoid the pos tthrombotic syndrome. Mechanical removal of the thrombus in the form o f venous thrombectomy should yield better long-term results. The purpo se of our study was to analyze the clinical outcome and venous valvula r function of limbs 5 to 13 years after iliofemoral venous thrombectom y. Methods: Seventy-seven lower extremities underwent venous thrombect omy for acute iliofemoral venous thrombosis and were monitored for a m ean follow-up of 8 1/2 years (range, 5 to 13 years). Patency of the il iofemoral venous system, competence of the femoral popliteal valves, a nd clinical signs and symptoms of chronic venous insufficiency were ev aluated in each case. Results: Subsequent to early perioperative failu re, patency remained stable over time at 84%. Valvular competence was preserved in 80% at 5 years; however, it decreased to 56% at 10 years. It is important that more than 90% of the limbs had no symptoms or mi ld symptoms of chronic venous insufficiency. Conclusions: Venous throm bectomy should be considered for primary treatment in selected cases o f early iliofemoral venous thrombosis.